The present invention relates to novel compounds having an anticoagulating action (so-called anticoagulants) and to their pharmacologically acceptable salts and solvates and hydrates, to pharmaceutical compositions comprising them as active ingredient, to processes for the preparation of such compounds, salts and compositions, and to the use thereof for the prevention and/or treatment of thromboembolic conditions. Those compounds, salts and compositions are very effective factor Xa inhibitors. The present invention relates also to pro-drugs, optically active forms, racemates and diastereoisomers of those compounds and salts.
Thromboembolic conditions are caused by an increased tendency to blood clotting in people with risk factors, such as, for example relatively major operations, prolonged immobilisation, fractures of the lower extremities, obesity, blood fat metabolism disorders, infections with gram-negative organisms, cancer and older age.
Venous thromboses may lead to the development of oedema or inflammation of the tissue drained by the affected vein. Thrombosis of a deeper vein (so-called deep vein thrombosis) may lead to serious complications, such as, for example, pulmonary embolism. Arterial thrombosis may lead to ischaemic necrosis of the tissue supplied by the affected artery, such as, for example, to myocardial infarct in the case of an affected coronary artery. Other thromboembolic conditions are, for example, arteriosclerosis, apoplexy (stroke), Angina pectoris, Claudicatio intermittens.
Under normal physiological conditions, natural blood clotting protects against greater blood loss from a damaged blood vessel. During blood clotting, liquid blood is converted into a blood clot, a gelatinous mass which seals injured blood vessels by forming a plug. In that process, soluble fibrinogen present in the plasma is converted into the fibrous-gelatinous clotting substance fibrin in a multi-stage process, the so-called coagulation cascade.
A distinction is made between two different processes for activating blood clotting. The intrinsic blood clotting process is initiated when blood comes into contact with non-physiological surfaces. The extrinsic blood clotting process is initiated by injury to blood vessels. Both blood clotting processes join in a common process in which the blood clotting factor X, a serine protease, is converted into its active form (factor Xa). Factor Xa, together with factor Va and Ca2+ in the so-called prothrombinase complex, causes prothrombin to be converted into thrombin which in turn, by removal of peptides, releases fibrin monomers from fibrinogen which are capable of coagulating to form fibrin fibres. Finally, factor XIII brings about cross-linking and thus stabilisation of the fibrin fibres.
Anticoagulants are used both for the prevention and for the treatment of thromboembolic conditions. As far as anticoagulants in the narrower sense are concerned, heparin, which is immediately effective and which directly inhibits certain blood clotting factors, is distinguished from the vitamin K antagonists (for example coumarin derivatives). The latter inhibit the production in the liver of certain clotting factors which is dependent on the presence of vitamin K, and begin to take effect only slowly. Other anticoagulant agents are the fibrinolytics, which bring about direct or indirect activation of the fibrinolytic system, and thrombocyte aggregation inhibitors, such as, for example, acetylsalicylic acid. A more seldom used method is reduction of the fibrinogen level in the blood by the enzyme ancrod. The object of using anticoagulant agents is to prevent the development of a blood clot that could close a vessel or also to dissolve it again once it has formed.
The above-mentioned anticoagulants in the narrower sense, i.e. heparin and vitamin K antagonists, have disadvantages. In the case of heparin, a distinction is made between unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH). A disadvantage with UFH is the fact that it generally has to be administered intravenously, has a varying anticoagulant effect and therefore necessitates frequent monitoring of the patient and adaptation of the dosage. Although LMWH can be used subcutaneously in a constant, unmonitored dosage, because of its short chain length its effect is greatly reduced in comparison with UFH.
The vitamin K antagonists, such as, for example, warfarin, exhibit differing degrees of activity from patient to patient, presumably owing to genetic factors. In addition to the slow onset of action mentioned above, it involves the disadvantage that patients have to be monitored and individual adaptation of the dosage is required.
Other known anticoagulants belong to the group of the thrombin inhibitors. Current synopses of the relevant research activity in that field can be found, for example, in Jules. A. Shafer, Current Opinion in Chemical Biology, 1988, 2: 458-485, Joseph P. Vacca, Current Opinion in Chemical Biology, 2000, 4: 394-400 and in Fahad Al-Obeidi and James A. Ostrem, DDT, Vol. 3, No. 5, May 1998: 223-231.
A crucial disadvantage of thrombin inhibitors is that, in order to obtain the desired effect, it is necessary to suppress thrombin activity in vivo to such a great extent that the tendency to haemorrhage may increase, which makes dosage difficult.
In contrast, factor Xa inhibitors cause suppression of the new formation of thrombin from prothrombin, whereas they do not impair existing thrombin activity which is necessary for primary haemostasis.
In addition to the above-mentioned synoptic articles, the following may be mentioned here by way of example: DE 197 43 435, DE 197 55 268, DE 198 19 548, DE 198 39 499 and WO 0031068.
The range of action and the range of side-effects of those factor Xa inhibitors have not yet been fully investigated in some cases.
An object of the present invention was to provide novel compounds having useful properties, especially an anticoagulating action.
More precisely, the object was to provide novel factor Xa inhibitors having improved activity, reduced side-effects and/or increased selectivity. In addition, suitable pharmaceutical compositions were to be provided. Those compounds and compositions were to be administrable especially orally.
A further object of the present invention was to provide a process for the preparation of those novel compounds.
Those novel compounds were furthermore to be suitable for use in the prevention and/or treatment of thromboembolic conditions.
The present invention describes anticoagulant compounds, their pharmacologically acceptable salts and solvates and hydrates and formulations that are novel, have a high activity and selectivity and can be administered orally. The present invention further relates to pro-drugs, optically active forms, racemates and diastereoisomers of those compounds and salts. The said compounds and salts may also themselves be pro-drugs which are activated only by metabolism. Pharmaceutical compositions comprising the said compounds or salts etc. as active ingredient are also described. A number of direct and simple syntheses of the compounds, pro-drugs, salts and compositions of the invention and of intermediates that are useful in such systems is also described. The use of those active ingredients for the prevention and/or treatment of thromboembolic conditions is also described.
The present invention relates to a compound of the general formula (I): 
wherein
X is Cl, Br or R1xe2x80x94Nxe2x95x90CH(xe2x80x94NH2)xe2x80x94 wherein
R1 is H, xe2x80x94OH, xe2x80x94C(xe2x95x90O)OR2, alkyl, aralkyl, aralkyloxy or a heteroalkyl group, such as, for example, alkoxy, acyl or acyloxy, wherein R2 is alkyl, such as methyl, ethyl or tert.-butyl, heteroalkyl, a carbocyclic group, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl or aralkyl, such as benzyl;
Ar is arylene, heteroarylene, heteroarylalkylene or aralkylene, X being bonded directly to the aromatic ring system;
R3 is H, alkyl, such as C1-C4-alkyl, heteroalkyl or aralkyl;
the groups R4 independently of one another are alkyl groups that may be substituted by one or more xe2x80x94OH or xe2x80x94NH2 radicals, or are heteroalkyl groups, carbocyclic groups, heterocycloalkyl groups, aryl groups, heteroaryl groups or aralkyl groups, it being possible for those groups to be substituted by one or more unsubstituted groups selected from alkyl, heteroalkyl, such as, for example, alkoxy, acyl or acyloxy, a carbocyclic group, heterocycloalkyl, aryl, heteroaryl and aralkyl, or are hydroxyl groups or glycosyloxy groups;
n is an integer from 0 to 5, preferably 0, 1 or 2 (in accordance with a preferred embodiment n=o);
R5 is H, alkyl, heteroalkyl, a carbocyclic group, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl or aralkyl;
R6 and R7 independently of each other are H, alkyl, heteroalkyl, a carbocyclic group, heterocycloalkyl, such as, for example, aryl-heterocycloalkyl, aryl, heteroaryl, aralkyl or heteroarylalkyl, it being possible for those groups to be substituted by one or more preferably unsubstituted groups selected from alkyl, heteroalkyl, such as, for example, alkoxy, acyl or acyloxy, a carbocyclic group, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl, aralkyl, xe2x80x94OH and xe2x80x94NH2,
xe2x80x83or together form part of a heterocycloalkyl ring system, especially an arylheterocycloalkyl ring system, such as, for example, aryl- or heteroaryl-piperazinyl, or of a heteroaryl ring system, it being possible for those systems to be substituted by one or more preferably unsubstituted groups selected from alkyl, heteroalkyl, such as, for example, alkoxy, acyl or acyloxy, a carbocyclic group, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl, aralkyl, xe2x80x94OH and xe2x80x94NH2; and
R8 is H, alkyl, heteroalkyl, a carbocyclic group, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl or aralkyl or, together with R5, forms part of a heterocycloalkyl ring system;
or a pharmacologically acceptable salt, solvate, hydrate or a pharmacologically acceptable formulation thereof.
Owing to their substitution, compounds of formula (I) contain one or more centres of chirality. The present invention therefore includes both all pure enantiomers and all pure diastereoisomers and also mixtures thereof in any mixing ratio.
The expression alkyl refers to a saturated or at least partially unsaturated, straight-chain or branched hydrocarbon group having, for example, from 1 to 12 carbon atoms, preferably from 1 to 6 carbon atoms, for example a methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, tert.-butyl, n-hexyl, 2,2-dimethylbutyl, n-octyl, allyl, isoprenyl or hexa-2-enyl group.
The expression heteroalkyl refers to an alkyl group in which one or more carbon atoms have been replaced by at least one oxygen, nitrogen, phosphorus or sulphur atom, oxygen and nitrogen being preferred, for example an alkoxy group, such as, for example, methoxy or ethoxy, or a methoxymethyl, cyano or 2,3-dioxyethyl group. The expression heteroalkyl further refers to a carboxylic acid or to a group derived from a carboxylic acid, such as, for example, acyl, acyloxy, carboxyalkyl, carboxyalkyl ester, for example methyl carboxyalkyl ester, carboxyalkylamide, alkoxycarbonyl or alkoxycarbonyloxy.
The expression carbocyclic group refers to a saturated or partially unsaturated, cyclic group that has one or more rings forming a structure that contains, for example, from 3 to 14 carbon atoms, preferably 5 or from 6 to 10 carbon atoms, for example a cyclopropyl, cyclohexyl, tetraline or cyclohex-2-enyl group. A heterocycloalkyl group may furthermore be substituted by an unsubstituted alkyl, heteroalkyl, heteroaryl or aryl group.
The expression heterocycloalkyl refers to a carbocyclic group in which one or more carbon atoms independently of one another have been replaced by an oxygen, nitrogen, phosphorus or sulphur atom. A heterocycloalkyl group may furthermore be substituted by an unsubstituted alkyl, heteroalkyl, heteroaryl or aryl group, and may, for example, be a piperidine, morpholine, N-methylpiperazine or N-phenylpiperazine group.
The expression aryl refers to an aromatic cyclic group that has one or more rings and is formed by a structure that contains, for example, from 5 to 14 carbon atoms, preferably 5 or from 6 to 10 carbon atoms. In addition, an aryl group may be substituted by unsubstituted alkyl or heteroalkyl groups, OH, CN, NO2 or NH2, and may, for example, be a phenyl, naphthyl, 2-, 3- or 4-methoxyphenyl, 2-, 3- or 4-ethoxyphenyl, 4-carboxyphenylalkyl or 4-hydroxyphenyl group.
The expression heteroaryl refers to an aryl group in which one or more carbon atoms independently of one another have been replaced by an oxygen, nitrogen, phosphorus or sulphur atom. Preferably, only 1 or 2 carbon atoms are replaced. Examples of such groups are the 4-pyridyl, the 2-imidazolyl, the 3-pyrazolyl and the isoquinolinyl group.
The expression aralkyl refers to groups that, in accordance with the above definitions, comprise both aryl and alkyl groups and/or carbocyclic groups, for example benzyl or tetrahydronaphthalene groups. The expression heteroarylalkyl refers to aralkyl groups in which one or more carbon atoms independently of one another have been replaced by oxygen, nitrogen, phosphorus or sulphur atoms, for example the tetrahydroisoquinolinyl group, the 2- or 3-ethyl-indolyl group or the 4-methylpyridino group.
The expressions alkyl, heteroalkyl, carbocyclic group, heterocycloalkyl, aryl, heteroaryl, heteroarylalkyl and aralkyl also refer to groups in which one or more hydrogen atoms of such groups have been replaced by fluorine, chlorine, bromine or iodine atoms or by xe2x80x94OH, NH2 or SH radicals. Those expressions furthermore refer to corresponding groups that are substituted by unsubstituted alkyl, heteroalkyl, aralkyl or aralkyloxy groups.
The expressions arylene, heteroarylene, heteroarylalkylene and aralkylene refer to di-substituted aryl, heteroaryl, heteroarylalkyl and aralkyl groups, i.e. to groups carrying at least two substituents other than H.
In the context of the present invention, the expression xe2x80x9cglycosyloxy groupxe2x80x9d refers to a saccharide, especially a monosaccharide, preferably glucose or fructose, that is bonded by way of an xcex1- or xcex2-O-glycosyl bond.
Preference is given to compounds of the general formula (I) or (II) wherein X=R1xe2x80x94Nxe2x95x90C(xe2x80x94NH2)xe2x80x94.
Preference is also given to compounds of the general formula (I) wherein R1=H, OH or C1-C4-alkoxy, such as methoxy or ethoxy.
Preference is given in addition to compounds of the general formula (I) wherein Ar is a substituted or unsubstituted meta-phenylene.
Special preference is given to compounds of the general formula (I) wherein Ar is a meta-phenylene substituted in the para-position to X by an OH, NH2, C1-C4-alkoxy (for example methoxy), C1-C4-alkylamino or C2-C6-dialkylamino group or by a halogen atom (for example chlorine or fluorine).
Preference is furthermore given to compounds of the general formula (I) wherein R3=H.
Preference is furthermore given to compounds of the general formula (I) wherein the groups R4 independently of one another are an OH, xe2x80x94OCH2COOH, xe2x80x94COOH, C1-C4-alkoxy or glycosyloxy group or a halogen atom, such as, for example, F or Cl. Especially preferably, R4 is an xe2x80x94OCH2COOH, xe2x80x94COOH or xcex2-D-glucosyloxy group.
Preference is also given to compounds of the general formula (I) wherein R5 is H, C1-C6-alkyl, C1-C6-heteroalkyl or the side chain of a natural amino acid. Especially preferably, R5 is H or methyl.
Preference is also given to compounds of the general formula (I) wherein R6 and R7 together form part of an aryl- or heteroaryl-piperazinyl ring (especially preferably of a 4-aryl- or 4-heteroaryl-piperazinyl ring).
Preference is furthermore given to compounds of the general formula (I) wherein R8=H or C1-C6-alkyl, such as methyl.
Preference is also given to compounds of the general formula (I) that have the following structure (II): 
wherein R1 is H, OH or C1-C4-alkoxy, such as methoxy or ethoxy; R4 independently of one another are an OH, xe2x80x94OCH2COOH, xe2x80x94COOH, C1-C4-alkoxy or glycosyloxy group (especially preferably a xcex2-D-glucosyloxy group) or a halogen atom, such as, for example, F or Cl; n is 0, 1 or 2, preferably 0 or 1; R5 is H or a C1-C4-alkyl group, such as a methyl group; R9 is H, OH F or a C1-C4-alkoxy group (especially preferably methoxy); R10 is H, a halogen atom (especially preferably F), CN, NO2 or a C1-C4-alkoxy group (especially preferably methoxy); Y is N or CR11 and R11 is H, a halogen atom (especially preferably F), CN, NO2 or a C1-C4-alkoxy group (especially preferably methoxy).
Examples of pharmacologically acceptable salts of compounds of formula (I) or (II) are salts of physiologically acceptable mineral acids, such as hydrochloric acid, sulphuric acid and phosphoric acid; or salts of organic acids, such as methanesulphonic acid, p-toluenesulphonic acid, lactic acid, acetic acid, trifluoroacetic acid, citric acid, succinic acid, fumaric acid, maleic acid and salicylic acid. Compounds of formula (I) or (II) can be solvated, especially hydrated. The hydration may take place, for example, during the preparation process or as a consequence of the hygroscopic nature of the initially anhydrous compounds of formula (I) or (II).
The pharmaceutical compositions according to the present invention comprise at least one compound of formula (I) or (II) as active ingredient and optionally excipients and/or adjuvants.
The pro-drugs to which the present invention also relates consist of a compound of formula (I) or (II) and at least one pharmacologically acceptable protecting group that is removed under physiological conditions, for example an alkoxy, aralkyloxy, acyl or acyloxy group, such as, for example, an ethoxy, benzyloxy, acetyl or acetyloxy group.
Compounds of formula (I) or (II) in which X is a cyano group serve as starting materials for the synthesis of said biologically active compounds. Those compounds can be synthesised by processes that are generally known for the formation of amide bonds. For example, an acid compound of formula (III) and an amine compound of formula (IV) 
in a solvent, such as dimethylformamide, can be linked together with a coupling reagent, such as carbonyldiimidazole or dicyclohexyl carbodiimide, and 1-hydroxybenzotriazole.
Compounds of formula (III) in which X is a cyano group can be synthesised by reacting an amine of formula (V) in which X is a cyano group with an xcex1-keto acid of formula (VI) 
for example in a solvent, such as ethanol or methanol, for example using sodium cyanoborohydride and catalytic amounts of acetic acid.
Alternatively, compounds of formula (III) can be synthesised by reacting an xcex1-bromic acid with a base, such as sodium hydroxide, evaporating the solvent and adding an excess of an amine of formula (V), and heating the resulting mixture at a preferred temperature of from 80 to 120xc2x0 C. over a period of several hours.
Compounds of formula (III) can alternatively be synthesised also by reacting an aldehyde, such as 3-cyanobenzaldehyde, with an amino acid in an aqueous solution of a base, such as sodium hydroxide, and adding, for example, sodium cyanoborohydride, preferably at a temperature below 5xc2x0 C.
In a preferred method for the stereoselective synthesis of compounds of formula (I) or (II), compounds of formula (III) are synthesised by reacting an aryl bromide, such as, for example, 3-bromobenzonitrile, with a phenylglycine derivative, such as, for example, (S)-phenylglycine. That synthesis can be carried out, for example, analogously to the process described in: D. Ma et al., J. Amer. Chem. Soc. 1998, 120:12459-12467. In the case of the compounds prepared stereoselectively in that manner, it was found that both the compounds of formula (I) or (II) having the (R)-configuration at the phenylglycine unit and the corresponding compounds having the (S)-configuration are very effective factor Xa inhibitors, the compounds having the (S)-configuration exhibiting, with identical substitution, slightly better inhibitory properties. In the case of the second amino acid unit of the general formula (I) or (II), the compounds having the (S)-configuration are similarly the somewhat better factor Xa inhibitors, while the corresponding compounds having the (R)-configuration are also very effective factor Xa inhibitors. According to the invention, preference is therefore given to compounds of formula (I) or (II) having the S,S-configuration, with compounds having the R,S-, S,R- and R,R-configuration also exhibiting very good inhibitory properties and forming part of the invention.
Compounds of formula (IV) can be synthesised by synthesising a N-Boc-protected amino acid with an amine of formula (XI) using standard linking methods with a coupling reagent, such as carbonyldiimidazole or dicyclohexyl carbodiimide, and 1-hydroxybenzotriazole. Compounds of formula (IV) can also be synthesised by using the mixed anhydrides or 4-nitrophenyl esters of the corresponding N-Boc-protected amino acids. Removal of the protecting group at the amine group by treatment with an acid, such as hydrochloric acid, trifluoroacetic acid or formic acid, in water or dichloromethane results in the end compounds of formula (IV).
Compounds of formula (I) in which X is xe2x80x94CN or xe2x80x94C(xe2x95x90NH)NH2 and R8 is H can be synthesised according to the invention also in one step by reacting together an amine of formula (VII), an aldehyde of formula (VIII) and an isonitrile of formula (IX), for example in a solvent, such as methanol, isopropanol, ethanol, chloroform, acetonitrile, dichloromethane, or a solvent mixture, for example methanol/water, isopropanol/water, acetonitrile/water or chloroform/water. 
The described reaction can be catalysed by the addition of Brxc3x6nsted acids, such as p-toluenesulphonic acid or 2,4-dinitrobenzenesulphonic acid, or Lewis acids, such as zinc dichloride, iron trichloride, boron trifluoride etherate or ytterbium triflate.
Compounds of formula (IX) can be synthesised by reacting an isonitrile of formula (X) with an amine of formula (XI) 
in a solvent, such as methanol, dichloromethane or dimethylformamide, or also without solvent, for example at room temperature or at a temperature up to 80xc2x0 C. (cf. K. Matsumoto et al., Synthesis, 1997, 249-250).
The above-mentioned starting compounds, especially the compounds of formulae (VII), (VIII), (XI), (V) and (VI), are commercially available or can be prepared by processes known from the literature. Compounds of formula (X) can be synthesised by the known process according to I. Ugi (ed. I. Ugi, Isonitrile Chemistry in Organic Chemistry, Volume 20, Academic Press, 1971, New York and London).
To convert xe2x80x94CN into xe2x80x94C(xe2x95x90NH)NH2, the starting nitrile can be dissolved in a solvent, such as ethanol or methanol, or a solvent mixture, such as chloroform and methanol or chloroform and ethanol, and that solution can be exposed to a stream of anhydrous hydrogen chloride at a temperature below 10xc2x0 C. After a reaction time of from several hours to days, the intermediate is precipitated with ether and filtered off. That intermediate can be dissolved in water and extracted with a solvent, such as dichloromethane, chloroform or ethyl acetate, after neutralisation with a base, such as sodium carbonate or sodium hydroxide. The resulting material is then reacted with anhydrous ammonia or an ammonium salt, such as ammonium chloride, in a solvent, such as methanol or ethanol, preferably at a temperature up to 80xc2x0 C. Alternatively, the filtered intermediate can be immediately reacted with anhydrous ammonia or an ammonium salt, such as ammonium chloride, in a solvent, such as methanol or ethanol.
To convert xe2x80x94CN into xe2x80x94C(xe2x95x90Nxe2x80x94OH)NH2, the starting nitrile can be dissolved in a solvent, such as dimethylformamide or ethanol, and the solution can be added to a reaction mixture of a base, such as sodium, sodium hydride or triethylamine, and hydroxylamine or a hydroxylamine salt, such as hydroxylamine hydrochloride, in a solvent, for example dimethylformamide or ethanol, preferably at a temperature below 5xc2x0 C. To convert xe2x80x94CN into xe2x80x94C(xe2x95x90Nxe2x80x94R1)NH2 wherein R1 is alkoxy, the corresponding alkylhydroxylamine is used in place of hydroxylamine.
To convert xe2x80x94CN into xe2x80x94C(xe2x95x90NH)NH2, conversion can first be carried out according to the above process into a compound (I) in which X is xe2x80x94C(xe2x95x90Nxe2x80x94OH)NH2. In a second step, by dissolving in a solvent, such as ethanol or acetic acid, that compound is then hydrogenated using a catalyst, for example palladium or palladium-on-carbon or platinum or Raney nickel, in a hydrogen atmosphere.
Compounds of formula (I) in which R1 is xe2x80x94C(xe2x95x90O)OR2 can be synthesised by reacting a compound of formula (I) in which R1 is H in a solvent, such as dimethylformamide or dichloromethane, with a chloroformic acid ester of the formula ClC(xe2x95x90O)OR2.
The compounds of formula (I) prepared by one of the processes described above can be separated into the individual stereoisomers by means of HPLC.
After synthesis, compounds of formula (I) wherein X=xe2x80x94C(xe2x95x90Nxe2x80x94R1)NH2 may optionally be converted into a physiologically acceptable salt, solvate or hydrate.
A compound or pharmaceutical composition of the present invention can be used for inhibiting factor Xa activity, for the prevention and/or treatment of thromboembolic conditions, arterial restenosis, septicaemia, cancer, acute inflammation or other conditions mediated by factor Xa activity, and especially venous thromboses, oedema or inflammation, deep vein thrombosis, pulmonary embolisms, thromboembolic complications after relatively major operations, in the case of vascular surgery, prolonged immobilisation, fractures of the lower extremities etc., arterial thromboses, especially of the coronary vessels in the event of myocardial infarct, and arteriosclerosis, apoplexy, Angina pectoris, Claudicatio intermittens, to mention but a few indications.
In general, as mentioned at the beginning, the active ingredients according to the invention are to have an inhibitory action towards factor Xa that is as great as possible while having a selectivity that is as high as possible. The selectivity was assessed in the present case by comparing the inhibitory action towards factor Xa and also tryptase and thrombin (two further serine proteases).
As mentioned above, the therapeutic use of the compounds of formula (I) or (II), their pharmacologically acceptable salts and solvates and hydrates and also formulations and pharmaceutical compositions are within the scope of the present invention.
The present invention relates also to the use of those active ingredients for the preparation of medicaments for the prevention and/or treatment of thromboembolic conditions. In general, compounds of formula (I) or (II) are administered either individually or in combination with any other desired therapeutic agent, using the known and acceptable modes. Such therapeutically useful agents can be administered by one of the following routes: orally, for example in the form of dragees, coated tablets, pills, semi-solid substances, soft or hard capsules, solutions, emulsions or suspensions; parenterally, for example in the form of an injectable solution; rectally in the form of suppositories; by inhalation, for example in the form of a powder formulation or spray, transdermally or intranasally. For the preparation of such tablets, pills, semi-solid substances, coated tablets, dragees and hard gelatin capsules, the therapeutically usable product can be mixed with pharmacologically inert, inorganic or organic excipients, for example with lactose, sucrose, glucose, gelatin, malt, silica gel, starch or derivatives thereof, talcum, stearic acid or salts thereof, skimmed milk powder and the like. For the preparation of soft capsules, excipients such as, for example, vegetable oils, petroleum, animal or synthetic oils, wax, fat and polyols can be used. For the preparation of liquid solutions and syrups, excipients such as, for example, water, alcohols, aqueous saline solution, aqueous dextrose, polyols, glycerol, vegetable oils, petroleum and animal or synthetic oils can be used. For suppositories, excipients such as, for example, vegetable oils, petroleum, animal or synthetic oils, wax, fat and polyols can be used. For aerosol formulations, compressed gases that are suitable for the purpose can be used, such as, for example, oxygen, nitrogen and carbon dioxide. The pharmaceutically acceptable agents may also contain additives for preserving and stabilising, emulsifiers, sweeteners, flavourings, salts for altering the osmotic pressure, buffers, enclosure additives and anti-oxidants.
Combinations with other therapeutic agents may comprise other active ingredients that are customarily used for the prevention and/or treatment of thromboembolic conditions, such as, for example, warfarin etc.
For the prevention and/or treatment of the conditions mentioned above, the dosage of the biologically active compound according to the invention can be varied within wide limits and can be adjusted to individual requirements. In general, a dosage of from 0.1 xcexcg to 10 mg/kg of body weight per day is suitable, a preferred dosage being from 0.5 to 4 mg/kg per day. In suitable cases, the dosage may also be below or above the stated values.
The following Examples are intended to illustrate the invention. The stereochemistry of 3,4,5-trihydroxy-6-hydroxymethyl-tetrahydropyran-2-yloxy corresponds to that of xcex2-D-glucose.